@article{AJO5203,
author = {Chelsea L. Heaven and Cheerag B. Patel and Kate O’Connor and John Chaplin and Nick McIvor and Andrew Macann and Subhaschandra Shetty},
title = {Perineural spread of head and neck cancer to the great auricular nerve: a case series},
journal = {Australian Journal of Otolaryngology},
volume = {9},
number = {0},
year = {2026},
keywords = {},
abstract = {Background: Head and neck cancers include tumours of the oral cavity, pharynx, larynx, nasal cavity, sinuses, thyroid, salivary glands and skin of the head and neck region. High risk tumour features, including perineural invasion and perineural spread (PNS), impact survival outcomes. While PNS to the trigeminal and facial nerves is well recognised, involvement of the great auricular nerve (GAN) is exceedingly rare, with limited cases described in the literature. This study aimed to describe the clinical and radiological characteristics of GAN PNS in head and neck cancers through a retrospective case series and literature review.Case Description: A retrospective, multi-centre case series was conducted across a New Zealand head and neck cancer database between 2017 and 2022. Five cases of head and neck cancer with PNS to the GAN were identified: three cases of squamous cell carcinoma (SCC), one of basal cell carcinoma (BCC), and one case of carcinoma ex-pleomorphic adenoma of the parotid gland with squamous transformation. Three cases presented with altered sensation in the GAN distribution, and three had radiological changes. All cases were discussed at a regional head and neck cancer multidisciplinary meeting, and four proceeded to surgical resection. Three patients received post-operative radiotherapy, and one underwent chemoradiotherapy. Follow-up ranged from 29 days to 55 months.Conclusions: PNS of head and neck cancer to the GAN is a rare occurrence that impacts disease and survival outcomes. PNS to the GAN should be specifically assessed both clinically and radiologically. Pre-operative identification of PNS to the GAN may alter treatment decisions, including surgical planning and radiotherapy fields.},
issn = {2616-2792}, url = {https://www.theajo.com/article/view/5203}
}